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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q s� Date: 8/2719 Permit Number: l o- ©sqy Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential Y PERMIT TYPE: GAS WATER HEATER PROPOSED IMPROVEMENT LOCATION: 4ddress: 1709 YORK CT. Property Tax ID #: 2421-601-0045-000-1 Site Plan Name: Project Name: DETAILED DESCRIPTION OF WORK: CHANGE OUT 40 GALLON GAS WATER HEATER. i CONSTRUCTION INFORMATION: Lot No._ Block No. Additional work to be performed under this permit —check all that apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Electric _ Plumbing Total Sq. Ft of Construction: Cost of Construction: $ 500.00 Sprinklers _ Generator _ Roof Pitch Sq. Ft. of First Floor: Utilities: _Sewer _Septic Building Height: OWNERAESSEE: CONTRACTOR: Name ROBERT CINEUS Name: CHRIS JOHNSON Address: 1709 YORK CT. Company: CNJ PLUMBING LLC Address: 1701 S. 37TH ST. City: FT. PIERCE State: _ City: FT. PIERCE State. FL Zip Code: 34982 Fax: Phone No. 813-455-5575 Zip Code: 34947 Fax: E-Mail: , Phone No 772-801-3073 Fill in fee simple Title Holder on next page (if different E-Mail CHRISJOHNSON@FPUA.COM from the 'Owner listed above) State or County License 30950 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: `OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. I certify that no work or installation has commenced prior to the issuance of a permit. St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. The following building permit applications are exempt from undergoing a full concurrency review: room additions, accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTQRNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Signature of Owner/ Lessoehlractor as Agent for Owner Signature of Contractor/License Hol STATE OF FLORIDA STATE OF FLORIDA ` COUNTY OF COUNTY OF i The forgoing instrument was acknowledged before me this day of 2q'� by The forgoing instrument was acknowledged before me this Pt day of 20_6 by Name of person malZing stateme t. Name of person makirillstatemen Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced j (Sign ure, f Notary Public- Statet,6f Florida) <"?g9�: INGRAM-RAHMINC; Commission No. .�: �I MY COMMISSION # GG 27506�) i ' 'a;` EXPIRES: December 2G 2U%" ignature of No ry. rq. HAHNA INGRAiM—RAH' T, ! - :*: CV7YCOMMISSI 275Q60 i bmmission No. _ nn `3g ;.,F oQ; IRES: December'20, 2C22 f °j F, Bonded e: l B0r'd ry Public lln tirr ora REVIEWS ut� FRONR.r. r v� Bonded Thru ,,.,,,• tary Public No Public Urd rtsd:, rs LANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.2/7/19